| Doctor Name: | MARY WITTMAN |
| NPI Number: | 1093026213 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 2202006043 |
| Business Practice Address: | 7617 Little River Tpke Suite 310 Annandale, VA - 220032603 |
| Business Phone Number: | 7039417757 |
| Business Fax Number: | 7039410587 |
| Mailing Address: | 7617 Little River Tpke, Suite 310 ANNANDALE |
| State: | VA |
| Postal Code: | 220032603 |
| Phone Number: | 7039417757 |
| Fax Number: | 7039410587 |
| NPI Enumeration Date: | 06/23/2010 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2202006043 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |